Southern Charm Family Healthcare

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTHERN CHARM FAMILY HEALTHCARE

Practice address

1201 Highway 49 S Ste 46
Richland, MS 39218-9438

Phone

(601) 829-6151

Fax

(769) 241-0044

NPI assigned

Mar 17, 2021

Last updated

Dec 8, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelli Marie Foster, NP-CNPI 1346887353

Title

Owner

Phone

(601) 829-6151

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southern Charm Family Healthcare LLC Other name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelli Marie Foster, APRN NP-C

  • Family Medicine Physician
  • Richland, MS
  • NPI 1346887353
  NPD Authorized official
• Kathryn Elisabeth Fuller, NP

  • Nurse Practitioner
  • High Point, NC
  • NPI 1881331593

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1801471172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BELLE OAK PL",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390428111",
            "telephone_number": "601-829-6151",
            "fax_number": "769-241-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HIGHWAY 49 S STE 46",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392189438",
            "telephone_number": "601-829-6151",
            "fax_number": "769-241-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CHARM FAMILY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-829-6151",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00936767",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Charm Family Healthcare LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kendra Shell
• Steven Dewitt Shields, RPH
• Ronald Earl Skelton, RPH
• Tyler Smith
• South Rankin Family Clinic, LLC
• St. Joseph Hospice of West Mississippi, LLC
• Samantha Danielle Statham, NP
• Transforming Minds Therapeutic Counseling Services, LLC
• Justin Traylor, ATC
• Rosa M Verneuille, O.T.

• Family Medicine Physician in Richland, MS
• Providers in Richland, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.